Provider Demographics
NPI:1093087116
Name:TULICK, ANNE (SLP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:TULICK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 BERRYS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:WHITE POST
Mailing Address - State:VA
Mailing Address - Zip Code:22663-2639
Mailing Address - Country:US
Mailing Address - Phone:240-644-8939
Mailing Address - Fax:
Practice Address - Street 1:325 BERRYS FERRY RD
Practice Address - Street 2:
Practice Address - City:WHITE POST
Practice Address - State:VA
Practice Address - Zip Code:22663-2639
Practice Address - Country:US
Practice Address - Phone:240-644-8939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007672235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist